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https://www.readbyqxmd.com/read/28730246/spontaneous-cholecystocutaneous-fistula-as-a-primary-manifestation-of-gallbladder-adenocarcinoma-associated-with-gallbladder-lithiasis-case-report
#1
Bogdan Vasile Micu, Octavian Aurel Andercou, Carmen Maria Micu, Valentin Militaru, IonuŢ Isaia Jeican, Cătălina Ileana Bungărdean, Stelian ŞtefăniŢă Mogoantă, Dan Radu Miclăuş, Tudor Radu Pop
Spontaneous cholecystocutaneous fistula (SCF) is a rare complication of neglected calculous biliary disease and also an extremely rare complication of gallbladder neoplasm. This pathology has become even rarer because of prompt diagnosis and expedient surgical intervention for gallstones. So far, there is one published report of a SCF due to gallbladder adenocarcinoma. We present the case of a woman aged 87 years, admitted to the Vth Department of Surgery, Clinical Municipal Hospital of Cluj-Napoca (Romania) for a tumoral mass located in the epigastrium...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#2
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#3
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#4
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28668919/feasibility-of-continuous-actigraphy-in-patients-in-a-medical-intensive-care-unit
#5
Biren B Kamdar, Daniel J Kadden, Sitaram Vangala, David A Elashoff, Michael K Ong, Jennifer L Martin, Dale M Needham
BACKGROUND: Poor sleep and immobility are common in patients in the medical intensive care unit (MICU) and are associated with adverse outcomes. Interventions to promote sleep and mobilization in the MICU are gaining popularity, but feasible instruments to measure their effectiveness are lacking. Actigraphy may be useful for large-scale, continuous measurement of sleep and activity, but its feasibility in MICU patients has not been rigorously evaluated. OBJECTIVE: To evaluate the feasibility of continuous actigraphy measurement in consecutive MICU patients...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28651311/outcomes-of-very-elderly-%C3%A2-80-years-critical-ill-patients-in-a-medical-intensive-care-unit-of-a-tertiary-hospital-in-korea
#6
Seung Hun Lee, Tae Won Lee, Sunmi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim
BACKGROUND/AIMS: This study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital. METHODS: We retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients...
July 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28625262/-predictive-value-of-sofa-score-combined-agi-grading-system-in-elderly-patients-with-sepsis-a-retrospective-analysis-with-91-patients
#7
Lingling Wang, Rui Chen, Zexun Mo, Jiahui Dong, Zhaokun Sun, Fei Xiao, Shaoting Hu, Richeng Xiong, Jie Sun, Zhou Yu, Zhenhui Guo
OBJECTIVE: To explore the predictive value of sequential organ failure assessment (SOFA) score combined the acute gastrointestinal injury (AGI) grading system in critical elderly patients with sepsis. METHODS: A retrospective analysis was conducted. Elderly patients with sepsis aged > 60 years admitted to medical intensive care unit (MICU) of General Hospital of Guangzhou Military Command from March 2014 to December 2015 and experiencing critical care over 48 hours were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28612034/effects-of-laser-polarization-on-responses-of-the-fluorescent-ca-2-indicator-x-rhod-1-in-neurons-and-myelin
#8
Ileana Micu, Craig Brideau, Li Lu, Peter K Stys
Laser-scanning optical microscopes generally do not control the polarization of the exciting laser field. We show that laser polarization and imaging mode (confocal versus two photon) exert a profound influence on the ability to detect [Formula: see text] changes in both cultured neurons and living myelin. With two-photon excitation, increasing ellipticity resulted in a [Formula: see text] reduction in resting X-Rhod-1 fluorescence in homogeneous bulk solution, cell cytoplasm, and myelin. In contrast, varying the angle of a linearly polarized laser field only had appreciable effects on dyes that partitioned into myelin in an ordered manner...
April 2017: Neurophotonics
https://www.readbyqxmd.com/read/28571498/preliminary-analysis-of-a-modified-screening-tool-to-increase-the-frequency-of-palliative-care-consults
#9
Emily Hurst, Lenar Yessayan, Michael Mendez, Aws Hammad, Jeffrey Jennings
PURPOSE: Palliative care interventions have been shown to improve patient quality of life but the benefit may be less if interventions occur late in the patient's disease process. The objective of this study was to evaluate whether an objective screening tool could improve the frequency and timeliness of palliative care consultation. METHODS: Using a quasi-experimental design with 2 geographically separate medical intensive care units (MICUs), the control MICU continued existing consultation practice and the intervention MICU implemented a screening tool with each new admission...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28570269/zinc-deficiency-primes-the-lung-for-ventilator-induced-injury
#10
Francis Boudreault, Miguel Pinilla-Vera, Joshua A Englert, Alvin T Kho, Colleen Isabelle, Antonio J Arciniegas, Diana Barragan-Bradford, Carolina Quintana, Diana Amador-Munoz, Jiazhen Guan, Kyoung Moo Choi, Lynette Sholl, Shelley Hurwitz, Daniel J Tschumperlin, Rebecca M Baron
Mechanical ventilation is necessary to support patients with acute lung injury, but also exacerbates injury through mechanical stress-activated signaling pathways. We show that stretch applied to cultured human cells, and to mouse lungs in vivo, induces robust expression of metallothionein, a potent antioxidant and cytoprotective molecule critical for cellular zinc homeostasis. Furthermore, genetic deficiency of murine metallothionein genes exacerbated lung injury caused by high tidal volume mechanical ventilation, identifying an adaptive role for these genes in limiting lung injury...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#11
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28488929/mobile-diagnostic-units-for-rural-patients-in-colombia
#12
Luis Fernando Cifuentes
BACKGROUND: The literature on the use of mobile diagnostic units for the adult population is limited. This is a report for the first time in Colombia (Latin America) on the use of mobile diagnostic units for patients in rural areas and resolution of complex cases through telemedicine. INTRODUCTION: Telemedicine is an alternative because it takes advantage of advances in telecommunications and technology for the provision of health services to patients in rural areas of a country...
May 10, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28443390/an-integrative-index-for-predicting-extubation-outcomes-after-successful-completion-of-a-spontaneous-breathing-trial-in-an-adult-medical-intensive-care-unit
#13
Tsung-Ju Wu, Judith Shu-Chu Shiao, Hsin-Liang Yu, Ruay-Sheng Lai
BACKGROUND: Among respiratory predictors, rapid shallow breathing index (RSBI) has been a commonly used respiratory parameter to predict extubation outcomes. However, the outcome of prediction remains inconsistent. Regarding nonrespiratory predictors, serum albumin, hemoglobin, bicarbonate, and patients' alertness have been reported to be associated with successful weaning or extubation. We aimed to develop an integrative index combining commonly used predictors in the adult medical intensive care units (MICUs) and to compare the predictability of the index with RSBI...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28412642/impact-of-duration-of-hypotension-prior-to-norepinephrine-initiation-in-medical-intensive-care-unit-patients-with-septic-shock-a-prospective-observational-study
#14
Jayshil J Patel, Jonathan S Kurman, Ann Biesboer, Hasan Taha, Michael Katz, Aniko Szabo, Steven Q Simpson, Elizabeth R Jacobs
PURPOSE: To determine the impact of duration of hypotension prior to norepinephrine initiation on outcomes in MICU patients with septic shock. We hypothesized increased duration of hypotension prior to norepinephrine initiation would be associated with an increased risk for ICU mortality. MATERIALS AND METHODS: We conducted a prospective-observational study in the MICU of a single-center tertiary academic medical center. We enrolled 160 adults ≥18years old with septic shock...
April 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28392941/insulin-resistance-and-chronic-kidney-disease-in-patients-with-type-1-diabetes-mellitus
#15
Mihaela Vladu, Diana Clenciu, Ion Cristian Efrem, Mircea-Cătalin Forțofoiu, Anca Amzolini, Simona Tudorică Micu, Maria Moţa, Maria Forțofoiu
Background and Aims. Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods. The study was conducted over a period of three years (2010-2013) and included patients with DM registered in the Clinical Centre of Diabetes, Nutrition and Metabolic Diseases of Dolj county...
2017: Journal of Nutrition and Metabolism
https://www.readbyqxmd.com/read/28379571/safety-and-feasibility-of-a-protocolized-approach-to-in-bed-cycling-exercise-in-the-intensive-care-unit-quality-improvement-project
#16
Ibtehal Kimawi, Bryanna Lamberjack, Archana Nelliot, Amy Lee Toonstra, Jennifer Zanni, Minxuan Huang, Earl Mantheiy, Michelle E Kho, Dale M Needham
Background: : In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU. Objective: We investigated whether a standardized protocol for in-bed cycling is safe and feasible, and results in cycling for a longer duration and achieves a higher resistance. Design: A quality improvement (QI) project was conducted...
March 31, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28357623/impact-of-pharmaceutical-care-on-pain-and-agitation-in-a-medical-intensive-care-unit-in-thailand
#17
Pitchaya Dilokpattanamongkol, Viratch Tangsujaritvijit, Thanarat Suansanae, Chuthamanee Suthisisang
Background Currently, a lack of pharmaceutical care exists concerning pain and agitation in medical intensive care units (MICU) in Thailand. Pharmaceutical care focusing on analgesics/sedatives would improve clinical outcomes. Objective To investigate the impact of pharmaceutical care of pain and agitation on ICU length of stay (LOS), hospital LOS, ventilator days and mortality. Setting The MICU of a university hospital. Method A before/after study was conducted on mechanically ventilated patients receiving analgesics/sedatives...
March 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#18
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
June 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28285400/how-does-environmental-variation-affect-the-distribution-of-dragonfly-larvae-odonata-in-the-amazon-cerrado-transition-zone-in-central-brazil
#19
T P Mendes, A Luiza-Andrade, H S R Cabette, L Juen
This study investigated the effects of environmental variation on assemblages of dragonfly larvae (Odonata). We hypothesize that there is a significant correlation between species richness, species composition, and abundance of Odonata individuals, and habitat integrity and abiotic variables. To test this hypothesis, we sampled odonate larvae at 12 streams in the Suiá-Miçú River basin in Mato Grosso, Brazil, during three different periods of the year. Local physical and chemical variables (temperature, pH, turbidity, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), and oxidation reduction potential (ORP)) were measured at each site using a multi-parameter probe, and integrity was assessed using the Habitat Integrity Index (HII)...
March 11, 2017: Neotropical Entomology
https://www.readbyqxmd.com/read/28285068/reducing-unnecessary-laboratory-testing-in-the%C3%A2-medical-icu
#20
Nisha Kotecha, Janet M Shapiro, John Cardasis, Gopal Narayanswami
No abstract text is available yet for this article.
March 9, 2017: American Journal of Medicine
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